I. Field of the Invention
This invention relates generally to surgical apparatus, and more particularly to a handle for use with a deflectable endoscope which is human-engineered to permit the surgeon to control the deflection of the distal tip of the endoscope from the proximal end thereof and for manipulating a surgical instrument within the working lumen of the endoscope.
II. Discussion of the Prior Art
Over the past few years, significant advances have been made in the manner in which many surgical procedures are carried out. In so-called "minimally invasive surgery", often referred to by the acronym, MIS, rather than making large incisions to gain access to an internal organ or other tissue to be excised, small punctures are made allowing a viewing endoscope to be inserted and advanced to the organ or other tissue to be surgically addressed. The endoscope will typically include an elongated catheter having a plurality of lumens for accommodating optical fibers or fiber bundles so that light energy may be transmitted from a source at the proximal end of the endoscope to its distal tip for illuminating the surgical site. Other optical fibers may be used to transmit an image being illuminated back to the proximal end of the endoscope for viewing by the physician. Still another channel or lumen may be reserved for the surgical instrument itself, which is to be used to effect the cutting. Surgical instruments may typically include a laser fiber, when laser energy is to be used to cut or ablate the tissue, or may accommodate a variety of electrosurgical instruments, e.g., forceps, scalpel, or other devices for grasping and retracting tissue out through the working lumen.
Devices of the type described are now being used in a variety of laparascopic procedures, in percutaneous discectomies for resolving herniated disks in the spinal column, in arthroscopic surgery, etc.
A variety of endoscopes, also known in the art, include a steerable distal tip. Such an endoscope will commonly include a lumen containing a pull-wire whose distal end is anchored to the distal end portion of the endoscope and whose proximal end may be tensioned to thereby bend and deflect the distal end portion of the endoscope. By this means, the surgeon may gain purchase to areas to be surgically treated that cannot be reached head-on.
It is extremely desirable that the endoscope be provided with a handle at its proximal end where the handle includes the necessary controls for not only steering the distal tip of the endoscope, but also for controlling the longitudinal displacement of the surgical instrument contained within the working lumen of the endoscope. Generally speaking, prior art handles incorporating such controls have tended to be quite complex and expensive to manufacture making it cost-prohibitive to dispose of the endoscope after only a single use. As such, the prior art endoscopes had to be designed to permit them to be cleaned and sterilized between uses with different patients.